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Radiotherapy to the Head

If an oncologist has advised a course of radiotherapy to your head as part of your treatment, this page gives you general information and answers some of the questions you may have about the side effects of radiotherapy.

We hope you will find this helpful. If you have any further questions relating to your treatment, please do not hesitate to ask your radiographer, nurse or oncologist.

Possible short term (early) side effects

Early side effects are temporary and affect most patients. The side effects generally develop towards the end of your course or after finishing treatment and may last for a few weeks.

Effects on the skin

Towards the end of treatment some patients’ experience some changes in the skin affecting the area that has been treated. The skin may

Feel tight and uncomfortable

Become pink or red

Become dry and flaky

Itch

Your skin will be monitored by your radiographers during radiotherapy and you will be given advice on skincare.

Skin reactions may sometimes persist for up to six weeks after treatment has finished.

Skin care - what can I do to help?

Gently wash the treated area with warm water and a mild shampoo. Please do not use other hair products such as hair spray, gel etc as this might irritate your skin.

Avoid long, hot showers.

Don’t use shower gel, bubble bath, antiseptic, body lotion, aftershave, make up or perfume on the treated area. They can make your skin dry and sore.

Avoid hot sun. A wide-brimmed hat will keep you cool. Do not expose the treated area to the sun for long periods. Whilst in the sun the treated area should be covered completely or a high protective factor suncream (25 or above) should be applied. Do not use a sunbed as this could make the reaction worse.

Gently wash the treated area with warm water and a mild shampoo. Please do not use other hair products such as hair spray, gel etc as this might irritate your skin.

You may be given a moisturising cream to soothe the skin from the radiographers or nurses. Your oncologist may prescribe a cream if needed.

How should I look after my hair?

The hair in the treated area will get sparse, and after two or three weeks it will fall out. When it starts to fall out, it usually happens quickly. It may take just a couple of days for it to fall out completely.

Your hair should grow back after treatment but it may be a different colour or texture.

If you have a high dose of radiotherapy it may not grow back at all. If this is likely to happen, we will tell you.

We can arrange for you to have a wig before your hair falls out. We can match it to your own hair colour and style. If you would like to do this, please tell your radiographer.

Some women may prefer to wear a scarf or turban. Men may like to wear a cap. Choose whatever you are most comfortable with. A range of scarves and turbans are now available at the Charlie Bear shop in the main foyer at NCCC.

The scalp may become sore or tender just before the hair falls out. Treat your hair gently. After washing, rinse it well, pat it with a towel and let it dry naturally. It is best not to use a hairdryer, if you do, make sure you use the COLD setting.

Be gentle when you comb your hair. Use a wide-toothed comb.

Please ask at the Information Centre for more advice and guidance on coping with hair loss.

Other effects

You may get headaches or your vision may be affected. Please tell the radiographer, doctor or nurse.

You may feel sick or lose your appetite. Your sense of taste may change. You may not feel much like eating but it is important to try.

You may get headaches or your vision may be affected. Please tell the radiographer, doctor or nurse.

Try these tips…

eat little and often.

eat a bit of what you fancy!

smoking may make side effects worse. Try and reduce or stop if you can. Please ask if you need help with stopping smoking.

if you feel sick, please tell your radiographers. You may need some medication to help.

We can give you a leaflet with more tips and ideas and we can arrange for you to see a dietician for help, if you need it.

Tiredness / Fatigue

Radiotherapy can sometimes make you feel very tired especially towards the end of your course of radiotherapy and for a number of weeks following treatment. It may be a while before you feel able to do some of your usual activities. You should rest as much as you need to although gentle exercise may help.

Fatigue is something nearly everyone with cancer feels. It affects people differently and it is important to tell the health care team if you are feeling more tired than usual. There are some physical causes, such as anaemia that are treatable.

Please ask for a booklet on fatigue at the Information Centre in NCCC which may give you tips to help with this.

Your emotions

It is important to make time for yourself. Emotions associated with the reactions to a diagnosis of cancer may come to the surface at various stages during your treatment.

Don’t worry if you feel low, this is normal. If you need to talk to someone, please ask, we are here to help. We have a wide range of support services within the department, such as palliative care team, nurse specialists and social worker.

A clinical psychology service is also available at the NCCC on referral from your oncologist.

What else do I need to do?

Your condition or its treatment may affect your ability to drive therefore we would advise that you do not drive until at least one month after finishing treatment. This should allow time for any side effects to settle.

Your progress

You may also be seen once a week in a radiotherapy clinic by your oncologist or specialist radiographer. This will be an opportunity to discuss any concerns or problems you may have.

Please tell your treatment radiographers if you have any problems between appointments.

Possible long-term or permanent effects of treatment

The skin in the treated area may always be more sensitive to strong sunshine in the future. Even after your hair has grown back, you can protect your head by using a sun block or a sun cream of at least factor. Wearing a hat or cap is another option.

You may find that you can’t concentrate as well as you could before your treatment and your short-term memory may not be as good. These effects may not fully recover.

The skin in the treated area may always be more sensitive to strong sunshine in the future. Even after your hair has grown back, you can protect your head by using a sun block or a sun cream of at least factor. Wearing a hat or cap is another option.

Some people get more side effects than others. Everyone is different.

The side effects you get will depend on the part of your brain we are treating.

Sex

Sexual activity is personal to each individual and may be an aspect of your life about which you have concerns relating to your disease or treatment. You may have questions you wish to ask. Please talk to your oncologist, nurse or radiographer if you would like to talk about these issues confidentially.

There is more information available on this subject in the Information Centre at NCCC.

Pregnancy

It is very important that women are and become pregnant whilst undergoing radiotherapy. Please inform a member of staff immediately if you think you may be pregnant. You will be asked (if appropriate) to confirm that you are not pregnant by one of the radiographers before starting treatment.

After your radiotherapy has finished

The side effects of radiotherapy can continue for several weeks after treatment has finished.

Continue with your skincare routine until any changes return to normal.

Protect the treated area from extremes of weather, such as hot sun and cold winds.

You may feel lethargic after treatment. This may get worse for a few weeks after.

All of this is normal and the feeling will pass.

You will be given a discharge letter with a copy for your GP summarising any side effects you may have and any creams or medication you have been prescribed at NCCC.

You may be sent a follow up appointment to see your specialist team some weeks after finishing treatment. You should get a letter giving you a date and time for your appointment. Alternatively, you may be followed up by your GP.

You may find that your symptoms get worse for a while before you feel better. If you are worried about your side effects after your treatment has finished, please contact a member of your specialist team at NCCC or the specialist nurse at your referring hospital.